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Per Diem Risk Adjustment Specialist Jobs (NOW HIRING)

Upward Health

Manager of Risk Adjustment

Houston, TX

Manager of Risk Adjustment Upward Health is an in-home, multidisciplinary medical group providing ... Everyone on our team from our doctors, nurses, and Care Specialists to our HR, Technology, and ...

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Per Diem Risk Adjustment Specialist information

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$38K

$100.5K

How much do per diem risk adjustment specialist jobs pay per year?

As of Jul 28, 2026, the average yearly pay for per diem risk adjustment specialist in the United States is $94,940.00, according to ZipRecruiter salary data. Most workers in this role earn between $98,500.00 and $98,500.00 per year, depending on experience, location, and employer.

What is a Per Diem Risk Adjustment Specialist?

A Per Diem Risk Adjustment Specialist is a healthcare professional who works on an as-needed basis to review and analyze patient medical records for accurate documentation and coding. Their primary role is to ensure that diagnoses are properly captured for risk adjustment purposes, which affects healthcare reimbursement and quality measures. They often work remotely or on-site for healthcare organizations, focusing on compliance with regulatory standards and accuracy in coding practices. This position requires detailed knowledge of medical coding, risk adjustment models, and healthcare regulations.

What are the key skills and qualifications needed to thrive as a Per Diem Risk Adjustment Specialist, and why are they important?

To thrive as a Per Diem Risk Adjustment Specialist, you need a solid understanding of medical coding (ICD-10), health information management, and risk adjustment methodologies, typically supported by a coding certification such as CPC or CRC. Familiarity with electronic health records (EHRs), coding software, and risk adjustment platforms is essential for accurate data capture and reporting. Strong attention to detail, analytical thinking, and effective communication skills help ensure the integrity of clinical documentation and collaboration with providers. These skills are crucial for optimizing reimbursement, supporting regulatory compliance, and contributing to accurate patient risk profiling in healthcare organizations.

What are some common challenges faced by Per Diem Risk Adjustment Specialists, and how can they be addressed?

Per Diem Risk Adjustment Specialists often face the challenge of managing fluctuating workloads and adapting quickly to different healthcare settings or documentation systems. Since the role typically involves reviewing medical records for accuracy and completeness, staying updated on coding guidelines and payer requirements is crucial. To succeed, it's helpful to maintain strong organizational skills, be proactive in continuing education, and communicate effectively with permanent staff to clarify documentation or coding questions. Flexibility and attention to detail are key assets for overcoming these challenges and ensuring accurate risk adjustment reporting.

What is the difference between Per Diem Risk Adjustment Specialist vs Per Diem Claims Processor?

AspectPer Diem Risk Adjustment SpecialistPer Diem Claims Processor
Primary FocusAnalyzing and optimizing risk adjustment data for health plansProcessing daily insurance claims and payments
Required CredentialsKnowledge of healthcare coding, risk adjustment, and data analysisUnderstanding of claims processing and insurance policies
Work EnvironmentHealthcare offices, insurance companies, or remoteInsurance companies, healthcare providers, or remote
Industry UsageCommonly used in health insurance and risk adjustment sectorsUsed across insurance claims processing departments

The Per Diem Risk Adjustment Specialist focuses on analyzing risk data to improve health plan reimbursements, while the Per Diem Claims Processor handles daily claims processing tasks. Both roles are essential in healthcare insurance operations but differ in their core responsibilities and skill sets.

More about Per Diem Risk Adjustment Specialist jobs
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Per Diem Risk Adjustment Specialist jobs near you
Infographic showing various Per Diem Risk Adjustment Specialist job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 77% Full Time, 14% Part Time, and 8% Contract. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution, with an average salary of $94,940 per year, or $45.6 per hour.

Risk Adjustment Analyst

PCC MEDICAL HOLDINGS LLC

North Palm Beach, FL • On-site

$65K - $75K/yr

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Risk Adjustment Specialist – Primary Care
Location: Remote
Employment Type: Full-Time
Pay : $65K - $75K
About Us
Here at Physician Care Centers, we are a patient-centered primary care organization committed to delivering high-quality, value-based care. Our team partners with providers to improve patient outcomes while ensuring accurate clinical documentation and coding practices.
Position Overview
We are seeking a detail-oriented Risk Adjustment Specialist to support our value-based care initiatives. In this role, you will work closely with providers and clinical teams to ensure accurate documentation and coding of patient conditions, helping reflect the true complexity of our patient population.
What You’ll Do
  • Perform pre-visit and post-visit chart reviews to identify risk adjustment opportunities
  • Ensure accurate ICD-10-CM and HCC coding based on clinical documentation
  • Partner with providers to clarify diagnoses and improve documentation quality
  • Educate providers and staff on risk adjustment and coding best practices
  • Track and monitor Risk Adjustment Factor (RAF) scores and performance metrics
  • Support internal and external audits and ensure compliance with Centers for Medicare & Medicaid Services (CMS) guidelines
  • Stay current on coding updates and value-based care requirements
What We’re Looking For
  • 2+ years of experience in risk adjustment, medical coding, or primary care
  • Strong knowledge of ICD-10-CM and HCC coding
  • Certification such as CRC or CPC preferred
  • Experience working with electronic health records (EHRs)
  • Excellent attention to detail and analytical skills
  • Strong communication skills and ability to collaborate with providers
Why Join Us?
  • Competitive salary and benefits package
  • Opportunity to work in a growing value-based care environment
  • Collaborative and supportive team culture
  • Professional development and certification support